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Mechanically Isolated Stromal Vascular Fraction by
Nanofat Emulsification Techniques
Nicolas Bertheuil, Audrey Varin, Raphael Carloni, Paul Girard, Benoit
Chaput
To cite this version:
Nicolas Bertheuil, Audrey Varin, Raphael Carloni, Paul Girard, Benoit Chaput. Mechanically Isolated Stromal Vascular Fraction by Nanofat Emulsification Techniques. Plastic and Reconstructive Surgery, Lippincott, Williams & Wilkins, 2017, 140 (3), pp.508e-509e. �10.1097/PRS.0000000000003630�. �hal-01579829�
1
Plastic and Reconstructive Surgery Advance Online Article
DOI: 10.1097/PRS.0000000000003630
Mechanically isolated Stromal Vascular Fraction by Nanofat Emulsification techniques.
Nicolas Bertheuil, MD1,2,3,4, Audrey Varin, PhD, Raphael Carloni, MD1, Paul Girard, MD1,
Benoit Chaput, MD4,5
1 - Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, University of Rennes 1, Rennes, France.
2 - INSERM U917, University of Rennes 1, Rennes, France.
3 - SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France.
4 - STROMAlab, UMR5273 CNRS/UPS/EFS - INSERM U1031, Rangueil Hospital, Toulouse, France.
5 - Department of Plastic, Reconstructive and Aesthetic Surgery, Rangueil Hospital, University Paul Sabatier, Toulouse, France.
Corresponding author:
Dr Nicolas Bertheuil
Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, Rennes, France.
16 Boulevard de Bulgarie, 35200, Rennes
Phone: 00 33 2 99 26 71 68
Fax: 00 33 2 99 26 67 18
E-mail: nbertheuil@gmail.com
None of the authors has a financial interest in any of the products, devices, or drugs
2
Sir,
We read with great interest the manuscript titled “Mechanical Micronization of Lipoaspirates: Squeeze and Emulsification Techniques” by Mashiko et al 1. Foremost, we want to
congratulate the authors for this beautiful work that adds significant details to our knowledge
on mechanical extraction of stroma vascular fraction (SVF) of adipose tissue without
enzymatic digestion. Indeed, the authors demonstrated the possible presence of
adipose-derived stromal cells (ASCs) (CD45-/CD31-/CD34+ cells) in squeezed and emulsified fat.
The emusification technique developed by the author’s results in two distinct products: a solid
fraction (called REF) and a fluid fraction (called FEF). The analysis of the cell composition is
performed essentially to the solid portion which is different from the product called nanofat
by Tonnard 2. Indeed, Tonnard et al analyzed the liquid phase eg: the SVF obtained after a
similar technique without the two steps of centrifugation. The fluid portion is particularly
interesting in clinical practice for indications of regenerative surgery (post radiotherapy, burns sequelae…), whereas the solid portion maybe useful for intermediate indications between fat grafting (volumetric correction of defect) and nanofat grafting (regenerative surgery). This
new study characterizes a portion not studied until now.
We would like to discuss two points that has not been addressed by the authors.
First, in our opinion, it would be really interesting to determine if the ASCs
(CD45-/CD31-/CD34+) isolated by these two free enzymatic extraction methods are “classical”
adipose-derived stromal cells. Indeed, ASCs are characterized by different criteria 3 such as: their
ability to form colony-forming unit-fibroblasts cells (CFU-Fs), the ability to differentiate into
various cell types derived from the mesodermal lineage (bone, cartilage and adipose tissue)
and the presence of mesenchymal markers (CD105, CD73, CD90) which were not assayed by
3
Moreover, we demonstrated that the SVF obtained after emulsification of the fat with the
nanofat technique, described by Tonnard contains functional ASCs 4. Indeed, ASCs isolated
with this technique present all the criteria described below and are functional with
immunosuppressive properties characterized by the capability to decrease the proliferation of
human T cells. Functional ASCs, through secretion of paracrine factors can modulate
inflammation and can favorise angiogenesis, two factors that play an essential role in tissue
regeneration 5.
In conclusion, all changes in the technique of mechanical extraction of SVF cells can modify
cell composition and may alter cell properties. Therefore, SVF cells isolated with new
mechanical techniques has to be tested in vitro to demonstrate the presence of ASCs cells.
Moreover, presence of functional ASCs has to be determined to judge and to validate the use
of this new technique in the operating room and to choose the best regenerative mechanical
4
References:
1. Mashiko T, Wu SH, Feng J, et al. Mechanical Micronization of Lipoaspirates: Squeeze
and Emulsification Techniques. Plast Reconstr Surg;139(1):79-90.
2. Tonnard PL, Verpaele AM. Discussion: Mechanical Micronization of Lipoaspirates:
Squeeze and Emulsification Techniques. Plast Reconstr Surg;139(1):91-92.
3. Bourin P, Bunnell BA, Casteilla L, Dominici M, Katz AJ, March KL, Redl H, Rubin
JP, Yoshimura K, Gimble JM. Stromal cells from the adipose tissue-derived stromal vascular
fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of
the International Federation for Adipose Therapeutics and Science (IFATS) and the
International Society for Cellular Therapy (ISCT). Cytotherapy. 2013 Jun;15(6):641-8.
4. Chaput B, Bertheuil N, Escubes M, Grolleau JL, Garrido I, Laloze J, Espagnolle N,
Casteilla L, Sensebé L, Varin A. Mechanically Isolated Stromal Vascular Fraction Provides a
Valid and Useful Collagenase-Free Alternative Technique: A Comparative Study. Plast
Reconstr Surg;138(4):807-19.
5. Bertheuil N, Chaput B, Ménard C, Varin A, Garrido I, Grolleau JL, Sensébé L, Watier
E, Tarte K. Adipose-derived stromal cells: history, isolation, immunomodulatory properties
